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BackgroundPeriprocedural myocardial injury (PPMI) frequently occurs after transcatheter aortic valve implantation (TAVI), although its impact on long-term mortality is uncertain.MethodsWe performed a pooled analysis of Kaplan-Meier-derived individual patient data to compare survival in patients with and without PPMI after TAVI. Flexible parametric models with B-splines and landmark analyses were used to determine PPMI prognostic value. Subgroup analyses for VARC-2, troponin, and creatine kinase-MB (CK-MB)-defined PPMI were also performed.ResultsEighteen observational studies comprising 10,094 subjects were included. PPMI was associated with lower overall survival (OS) after two years (HR = 1.46, 95% CI 1.30–1.65, p

Several recent studies have investigated the opportunities of differential interferometry synthetic aperture radar (DInSAR) using satellite data for structural health monitoring (SHM) of civil structures. However, its use in structural engineering is still debated because of the lack of a general understanding of the potential and limitations of the technology for bridge SHM. To overcome this issue, specific methods of data processing and displacement assessment with error quantification need to be developed. The present paper aims at giving an insight into the use of small baseline subset-differential synthetic aperture radar interferometry (SBAS-DInSAR) as a remote-sensing technology for civil infrastructure monitoring combining information at a large scale with those associated with a single bridge. In particular, an operational framework for the selection and processing of a measurement time series representative of the structural behavior of the bridge of interest is designed in a way that fully remote characterization and assessment can be carried out by exploiting web-mapping platforms according to the crowd-sensing paradigm. The workflow, designed consistently with a structural engineering perspective, has been tested with reference to a number of bridges crossing the Tiber river in Rome (Italy), showing that the proposed fully remote monitoring procedure can effectively support satellite data processing and interpretation. Moreover, some issues in view of the general use of satellite data for bridge monitoring emerged from the study. Gaps in the measurement point distribution over the bridge decks are frequently observed over all the monitored area, therefore simplified methodologies aimed at estimating expected displacement ranges of different bridge typologies under serviceability loads have been defined enabling a rational interpretation of the data in the light of the selected radar sensor band of operation. Simplified formulations and charts for service and environmental loads are then presented with a twofold objective: (1) supporting the satellite data elaboration and interpretation by means of easy to manage open-source tools; and (2) providing estimates of the expected operational displacements of healthy structures to guide data interpretation and even algorithms for radar signals processing able to incorporate the response of structures to temperature variations. [ABSTRACT FROM AUTHOR]

This paper presents a contribution to reviewing the most common seismic design procedures of CLT buildings and their implications on structural features and technological solutions. Attention is particularly focused on the overall seismic performance, damage tolerance, construction costs and environmental impact. It is intended as a baseline for a more comprehensive study, thus the assessment is made with reference to a real building, representative of a class of common buildings recently designed and erected in many Italian regions exposed to low and moderate seismic hazards. As usual, the analysis was carried out according to a two-dimensional model of the panels, assumed to be elastic, varying the type of connections at the base, the presence of pre-stressing steel bars for rocking control and dissipative devices. The main outcomes of the study can be summarized as follows: (i) the structural seismic behavior of CLT buildings is significantly influenced by the structural schemes adopted for walls and connections; (ii) construction costs and environmental impact decrease whenever damage tolerance is accounted for in design procedures.

Aims Cardiogenic shock (CS) and cardiac arrest (CA) are serious complications in ST-elevation myocardial infarction (STEMI) patients, with lack of long-term data according to their timing of occurrence. This study sought to determine the incidence and relationship between the timing of occurrence and prognostic impact of CS and CA complicating STEMI in the long-term follow-up. Methods and results We conducted a retrospective analysis of consecutive STEMI patients treated between 2004 and 2017. Patients were divided into four groups based on the occurrence of neither CA nor CS, CA only, CS only, and both CA and CS (CA−CS−, CA+, CS+, and CA+CS+, respectively). Adjusted Cox regression analysis was used to assess the independent association between the CS and CA categories and mortality. A total of 1603 STEMI patients were followed for a median of 3.6 years. CA and CS occurred in the 12.2% and 15.9% of patients, and both impacted long-term mortality [adjusted hazard ratio (HR) = 2.59, 95% confidence interval (CI): 1.53–4.41, P < 0.001; HR = 3.16, 95% CI: 2.21–4.53, P < 0.001, respectively). CA+CS+ occurred in 7.3%, with the strongest association with higher mortality (adjusted HR = 5.36; 95% CI: 3.80–7.55, P < 0.001). Using flexible parametric models with B-splines, the increased mortality was restricted to the first ∼10 months. In addition, overall mortality rates were higher at all timings (all with P < 0.001), except for CA during initial cardiac catheterization (P < 0.183). Conclusion CS and CA complicating patients presenting with STEMI were associated with higher long-term mortality rate, especially in the first 10 months. Both CS+ and CA+ at any timeframe impacted outcomes, except for CA+ during the initial cardiac catheterization, although this will have to be confirmed in larger future studies, given the relatively small number of patients. [ABSTRACT FROM AUTHOR]

Oral bacteria are implicated not only in oral diseases but also in gut dysbiosis and inflammatory conditions throughout the body. The periodontal pathogen Aggregatibacter actinomycetemcomitans (Aa) often occurs in complex oral biofilms with Streptococcus gordonii (Sg), and this interaction might influence the pathogenic potential of this pathogen. This study aims to assess the impact of oral inoculation with Aa, Sg, and their association (Aa+Sg) on alveolar bone loss, oral microbiome, and their potential effects on intestinal health in a murine model. Sg and/or Aa were orally administered to C57Bl/6 mice, three times per week, for 4 weeks. Aa was also injected into the gingiva three times during the initial experimental week. After 30 days, alveolar bone loss, expression of genes related to inflammation and mucosal permeability in the intestine, serum LPS levels, and the composition of oral and intestinal microbiomes were determined. Alveolar bone resorption was detected in Aa, Sg, and Aa+Sg groups, although Aa bone levels did not differ from that of the SHAM-inoculated group. Il-1β expression was upregulated in the Aa group relative to the other infected groups, while Il-6 expression was downregulated in infected groups. Aa or Sg downregulated the expression of tight junction genes Cldn 1, Cldn 2, Ocdn, and Zo-1 whereas infection with Aa+Sg led to their upregulation, except for Cldn 1. Aa was detected in the oral biofilm of the Aa+Sg group but not in the gut. Infections altered oral and gut microbiomes. The oral biofilm of the Aa group showed increased abundance of Gammaproteobacteria, Enterobacterales, and Alloprevotella, while Sg administration enhanced the abundance of Alloprevotella and Rothia. The gut microbiome of infected groups showed reduced abundance of Erysipelotrichaceae. Infection with Aa or Sg disrupts both oral and gut microbiomes, impacting oral and gut homeostasis. While the combination of Aa with Sg promotes Aa survival in the oral cavity, it mitigates the adverse effects of Aa in the gut, suggesting a beneficial role of Sg associations in gut health. [ABSTRACT FROM AUTHOR]

Several genera of Nyctaginaceae, currently merged under Pisonia, have been described for the Indo-Pacific region. Results from a recent molecular phylogenetic study of tribe Pisonieae showed that Pisonia is non-monophyletic and comprises three well-supported lineages: one including typical Pisonia and allies (Pisonia s.str.), a clade of species which corresponds to the original description of Ceodes and a third lineage whose single representative was formerly treated under the monotypic genus Rockia. Thus, as part of an effort to achieve a natural classification for tribe Pisonieae, this work proposes to re-establish Ceodes and Rockia to accommodate taxa with inconspicuous glands on anthocarps, recognising 21 species (20 for the former and one for the latter), of which 16 are new combinations: Ceodes amplifolia comb. nov., Ceodes artensis comb. nov., Ceodes austro-orientalis comb. nov., Ceodes brownii comb. nov., Ceodes cauliflora comb. nov., Ceodes coronata comb. nov., Ceodes diandra comb. nov., Ceodes gigantocarpa comb. nov., Ceodes gracilescens comb. nov., Ceodes lanceolata comb. nov., Ceodes merytifolia comb. nov., Ceodes muelleriana comb. nov., Ceodes rapaensis comb. nov., Ceodes sechellarum comb. nov., Ceodes taitensis comb. nov. and Ceodes wagneriana comb. nov. A general distribution of each species recognised in this work is also included, along with line drawings and colour pictures of representative species of Ceodes, Pisonia and Rockia and an updated dichotomous key based on reproductive characters for the nine genera (Ceodes, Cephalotomandra, Grajalesia, Guapira, Neea, Neeopsis, Pisonia, Pisoniella and Rockia) comprising the tribe Pisonieae. Résumé Plusieurs genres de Nyctaginaceae actuellement fusionnés sous Pisonia ont été décrits pour la région Indo-Pacifique. Les résultats d’une récente étude phylogénétique moléculaire de la tribu Pisonieae ont montré que Pisonia est non monophylétique et comprend trois lignées bien supportées: une comprenant Pisonia typique et ses alliés (Pisonia s.str.), un clade d’espèces qui correspond à la description originale de Ceodes et une troisième lignée dont l’unique représentant était auparavant traité sous le genre monotypique Rockia. Ainsi, dans le cadre d’un effort pour parvenir à une classification naturelle de la tribu Pisonieae, ce travail proposons de rétablir les Ceodes et Rockia pour accueillir des taxons avec des glandes discrètes sur les anthocarpes, reconnaissant 21 espèces (20 pour les premières et une pour les dernières), dont 16 sont de nouvelles combinaisons: Ceodes amplifolia comb. nov., Ceodes artensis comb. nov., Ceodes austro-orientalis comb. nov., Ceodes brownii comb. nov., Ceodes cauliflora comb. nov., Ceodes coronata comb. nov., Ceodes diandra comb. nov., Ceodes gigantocarpa comb. nov., Ceodes gracilescens comb. nov., Ceodes lanceolata comb. nov., Ceodes merytifolia comb. nov., Ceodes muelleriana comb. nov., Ceodes rapaensis comb. nov., Ceodes sechellarum comb. nov., Ceodes taitensis comb. nov. et Ceodes wagneriana comb. nov. Une distribution générale de chaque espèce reconnue dans ce travail est également incluse, ainsi que des dessins au trait et des images en couleur des espèces représentatives de Ceodes, Pisonia et Rockia, et préparé une clé dichotomique mise à jour basée sur les caractères reproductifs des neuf genres (Ceodes, Cephalotomandra, Grajalesia, Guapira, Neea, Neeopsis, Pisonia, Pisoniella et Rockia) comprenant la tribu Pisonieae.

The structural and seismic fragility assessment of minor historical centers of the Inner Peripheries of Italy is a key phase of the preservation process of the historical and cultural features of a portion of the Italian building stock, whose reuse is crucial for the reversal of shrinking trends and the stimulation of population growth. In this framework, the opportunities offered by digital crowd-sourcing technologies with respect to performing probabilistic structural safety assessment at a large scale are investigated herein. The objective of this research was to exploit data and information available on the web such that the key building features of an area of interest are collected through virtual inspections, historical databases, maps, urban plans, etc. Thus, homogeneous clusters of buildings identified in the area of interest are catalogued and associated with specific building classes (chosen among those available in the literature), and the buildings’ levels of seismic fragility are determined through the development of fragility curves. The research outcomes show that the proposed approach provides a satisfactory initial screening of the seismic fragility level of an area, thus allowing for the identification of priority zones that require further investigations or structural interventions to mitigate seismic risk.

Background No study has evaluated the impact of the additional manipulation demanded by multiple resheathing (MR) in patients undergoing transcatheter aortic valve replacement with repositionable self‐expanding valves. Methods and Results This study included a real‐world, multicenter registry involving 16 centers from Canada, Germany, Latin America, and Spain. All consecutive patients who underwent transcatheter aortic valve replacement with the Evolut R, Evolut PRO, and Portico valves were included. Patients were divided according to the number of resheathing: no resheathing, single resheathing (SR), and MR. The primary end point was device success. Secondary outcomes included procedural complications, early safety events, and 1‐year mortality. In 1026 patients, the proportion who required SR and MR was 23.9% and 9.3%, respectively. MR was predicted by the use of Portico and moderate/severe aortic regurgitation at baseline (both with P

Os parâmetros da variabilidade da frequência cardíaca (VRR) têm se demonstrado de grande valor prognóstico para eventos arrítmicos graves e para a morte súbita cardíaca. Está comprovada a importância da atividade vagai como protetora contra a induçao de arritmias ventriculares. Por outro lado, sabemos que a hiperatividade simpática é arritmogênica. Baixa VRR indica predomínio simpático e, portanto, maior facilidade para a ocorrência de arritmias.

Due to the increasing environmental degradation, the understanding of how reforestation and other restoration techniques function became fundamental to base the reestablishment of degraded ecosystems. The aim of this study was to perform a vegetation survey in a restoration site through three different techniques. The study site has 7.2 ha in a subtropical forest in Dois Vizinhos, Paraná state, Brazil and it is approximately 20 m from a secondary forest fragment. The experiment consisted of 12 plots with three treatments (T1-3) randomly distributed in four blocks. T1: natural regeneration through passive restoration. T2: set of nucleation techniques. T3: seedlings planted through filling and diversity lines (3x2 m). For sampling purposes, each plot was divided into 24 subplots. In order to evaluate plant presence, two years and eight months after the treatments implementation, a survey was conducted in three random subplots for each plot, where all plants taller than 50cm were identified and quantified. Native species richness was higher than 87% in all treatments, whereas the presence of herbaceous species was higher at passive restoration and woody species at plantation. The most common dispersal syndromes were anemochory and zoochory. By comparing planted and regenerated individuals for the three treatments, the plantation technique had the highest Shannon diversity index (3.017), with 148 individuals and 53 species sampled. However, there was no statistically significant difference. This higher diversity is related to the larger number of species planted, but it is still not facilitating regeneration species in its understory at this age. Considering only regenerated individuals, nucleation showed the highest Shannon diversity index (2.078) with a total of 908 individuals of 40 species, however, it wasn’t statistically significant different of passive restoration (Shannon = 1.965) which had 2,018 individuals of 40 species. The most floristic similar treatments were passive restoration and nucleation. Nucleation facilitated species natural regeneration (17 planted and 40 regenerated species) while passive restoration showed high resilience, therefore the use of passive restoration can be considered an effective alternative since its results did not differ statistically from nucleation, and the main advantage of this technique is the reduced cost.

Há alguns anos o assunto “aparelhos autoligados“, não é considerado novidade na Ortodontia. Muitos estudos e relatos de caso envolvendo a eficiência desses aparelhos vem sendo publicados e discutidos na literatura. No entanto, apesar desse fato, existe ainda muita discussão relacionada a esse tema, no que se refere a comparação do sistema autoligado com o sistema convencional. Dessa forma, este trabalho buscou por meio de uma revisão aprofundada da literatura atual, comparar e ressaltar os prós e os contras do sistema autoligado em relação ao sistema convencional.

Foram estudados 8 (oito) pacientes portadores de marcapasso Micropacer, cujas funções de porcentagem de batimentos totais, estimulados, sentidos, porcentagem de estimulação, função Holter simplificada e histograma foram ativados e analisados com eletrocardiografia dinâmica (E. C. G. D.). As diferenças obsevadas foram: batimentos totais (0,04% a 2,7%), batimentos estimulados (0,17% a 11,6%), batimentos sentidos (0,09% a 56%), porcentagem de estimulação (0% a 4%). Contagem telemétrica média em faixa de frequencia (Actual Holter values) fol semelhante em 3 (tres) casos e 0 histograma em 7 casos.

Cross-laminated timber (CLT) buildings are recognized as a robust alternative to heavyweight constructions, because beneficial for seismic resistance and environmental sustainability, more than other construction materials. The lightness of material and the satisfactory dissipative response of the mechanical connections provide an excellent seismic response to multi-story CLT buildings, in spite of permanent damage to timber panels in the connection zones. Basically, CLT constructions are highly sustainable structures from extraction of raw material, to manufacturing process, up to usage, disposal and recycling. With respect to other constructions, the potential of CLT buildings is that their environmental sustainability in the phases of disposal and/or recycling can be further enhanced if the seismic damage in structural timber components is reduced or nullified. This paper reports a state-of-the art overview on seismic performance and sustainability aspects of CLT buildings in seismic prone regions. Technological issues and modelling approaches for traditional CLT buildings currently proposed in literature are discussed, focusing the attention on some research advancements and future trends devoted to enhance seismic performance and environmental sustainability of CLT buildings in seismic prone regions.